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Despite the evidence that the 2004 charging regulations that bar access to free NHS hospital care violate refused asylum seekers' human rights,1 the BMA has never acknowledged the fact. Now the government has raised the stakes immeasurably2—the years of confusion, procrastination, hounding, and denial of hospital care3 will appear small beer if its threat to also ban access to free primary care is implemented this October, as is widely expected.
An unconscionable disconnect exists between BMA high profile support for health rights, as reflected by Mary Robinson's prestigious launch of the BMA's Right to Health: a Toolkit for Health Professionals,4 and apparent institutional resistance to incorporate health rights into policy. As the toolkit says, the right to the highest attainable standard of health is a fundamental human right, protected by international law, and the state must refrain from denying equal access for asylum seekers and illegal immigrants.
The ethics department stipulation that the membership inform BMA policy5 has been met by the unequivocal 1997 instruction from the annula general meeting to the BMA Council “to campaign against embargoes which damage health.” On this occasion the government imposing sanctions is British and the victims live in the UK, but the ethical issues are identical.
As the chairman of the international committee proudly explained in his ARM speech, the toolkit provides a basis by which medical associations and populations can hold their governments to account regarding the provision of health care. If the BMA continues to disregard its own educational material, it will surrender its reputation for integrity and its status as an authority on human rights. If it persists in its role as the watchdog that failed to bark, and the government withdraws free access from all health care for refused asylum seekers, the medical profession will—to the extent that its passivity has shown a green light to the government's violation of international human rights law—share responsibility for the suffering and deaths that ensue.
Competing interests: PLH played a part in developing the General Comment 14 of the International Covenant on Economic, Social and Cultural Rights.